Immune reconstitution inflammatory syndrome presenting as superior vena cava syndrome secondary to Coccidioides lymphadenopathy in an HIV-infected patient.
A 39-year-old man living with AIDS presented with a swollen face. He was found to be HIV infected after presenting with Coccidioides pneumonia 2 years previously and was placed on daily fluconazole and then on highly active antiretroviral therapy. Computed tomography confirmed superior vena cava obstruction secondary to lymphadenopathy. Biopsy confirmed coccidioidomycosis with no evidence of malignancy. To our knowledge, this is the first description of superior vena cave syndrome secondary to coccidioidomycosis and the first description of immune reconstitution inflammatory syndrome involving Coccidioides.
Mortimer
Roger B
RB
Department of Family Medicine, University of California, San Francisco-Fresno Medical Education Program, Fresno, California 93701-2302, USA. rmortimer@fresno.ucsf.edu
Libke
Robert
R
Eghbalieh
Babak
B
Bilello
John F
JF
D017088:AIDS-Related Opportunistic Infections / Q000150:complications; D000328:Adult; D003045:Coccidioides; D003047:Coccidioidomycosis / Q000150:complications* / Q000382:microbiology; D015658:HIV Infections / Q000150:complications; D015497:HIV-1; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome; D008206:Lymphatic Diseases / Q000150:complications*; D008297:Male; D013479:Superior Vena Cava Syndrome / Q000150:complications* / Q000209:etiology